Tag: Addiction Medicine

Gabapentin as a Controlled Substance

This past Monday, 1/7/18, the state of Michigan classified Gabapentin (brand name Neurontin) as a controlled substance (C V) as it has been increasingly been reported abused by some patients.

Gabapentin is approved by the Food and Drug Administration (FDA) to treat epilepsy and neuropathic pain caused by shingles. That is it! However, as many people already recognize it is prescribed ‘off label’ by health care providers for various reasons including including depression, anxiety, migraine, fibromyalgia, muscle and joint pain, and bipolar disorder. According to some estimates, over 90% of Neurontin sales are for off-label uses. A report by IMS health found that 57 million prescriptions for Gabapentin were written in the U.S. in 2015, a 42% increase since 2011.

Many providers, including myself, have never screened for Gabapentin abuse in the past as this medication is not tracked by the state’s controlled substance tracking system nor is it typically detectable in most office-based urine drug screens. When Gabapentin is taken alone there is little potential for abuse. Yet, when taken with other drugs, such as opioids, muscle relaxants, and other anxiety medications, there are reports that Gabapentin can have a euphoric effect.

While I see the concern for making Gabapentin a controlled substance in Michigan, it is going to be a tremendous headache for everyone. The community, hospitals, treatment facilities, and doctor offices.

Isn’t it ironic that Michigan is locking up Gabapentin (which IS affordable and has good application when used appropriately) but legalizing marijuana?

It will eventually be easier for people to smoke a joint then get Gabapentin.

Currently, a month supply at Beyond Primary Care for 300 mg (90 pills) is $4.59. The street value for Gabapentin just went up because of this classification and that makes me concerned. Hell, the CDC lists Gabapentin as a non-opioid alternative treatment for pain control. This move by the State of Michigan makes my job as a physician, patient advocate, and provider certified in chronic pain management increasingly harder to deliver affordable and effective treatment to my patients.

Avoiding Resignation with Addiction

admin

30 October 2018

As an addiction specialist offering addiction services, I have yet to meet a patient who enjoys being addicted to drugs. Addiction is a chronic illness around which is a great deal of confusion, few people know what to do. Faced with someone who appears to be driving heedlessly into the abyss, families often fight, freeze or flee, unable to figure out how to help.

Consider the opioid epidemic. This month, this news organization estimated that more than 300,000 Americans will die of drug overdoses in the next five years. Why are health professionals and the government not acting on this knowledge? Tradition? Prejudice? Utmost stupidity? The answer is sometimes all three.

Often times we scroll the sidebar reading about the passing of great actors and celebrities, such as Philip Seymour Hoffman, Heath Ledger, Michael Jackson, and Prince. But what about those who stray off course closer to home, who don’t get the huge publicity? The suburban middle-aged man, who is a credible business man and decorated community leader but passed from pancreatitis due to chronic alcohol use. Or the aspiring young woman who quietly finished her first marathon and worked unglamorously towards saving for her first house, but OD’d on heroin.

I can assure you that there is no as yet undiscovered riddle to these people, the disease of addiction recognizes none of these distinctions. It is indiscriminate, it is sad, it is irrational, and it is hard to understand. But what we should articulate, as I have outlined in this youtube video explaining my treatment of addiction, is that these deaths are unnecessary and something should be done. Fortunately, our brains are remarkably plastic. I know it is far easier said than done, but there is a way to find control and life without drugs. For those brave enough to share, recovery stories such as this are incredible and worth every effort.